The CT Synergy (V3.1/V3.2/V3.3/V3.4/V3.5) Conformance Statement

GE EDICAL SYSTES STATEENT DIR 2210079 REV 1.0 CT Synergy DICO CONFORANCE REVISION HISTORY REV DATE REASON FOR CHANGE 0.3 December 2,1997 Initial Release 1.0 ay 22,2000 Revise for v3.2-3.5 LIST OF EFFECTIVE PAGES SECTION NUBER SECTION NUBER Title, p.1 1.0 3.0 Revision History / LOEP, p.2 1.0 3.0 2

Warning! THIS SERVICE ANUAL IS AVAILABLE IN ENGLISH ONLY IF A CUSTOER S SERVICE PROVIDER REQUIRES A LANGUAGE OTHER THAN ENGLISH, IT IS THE CUSTOER S RESPONSIBILITY TO PROVIDE TRANSLATION SERVICES. DO NOT ATTEPT TO SERVICE THE EQUIPENT UNLESS THE SERVICE ANUAL HAS BEEN CONSULTED AND UNDERSTOOD. FAILURE TO HEED THIS WARNING AY RESULT IN INJURY TO THE SERVICE PROVIDER, OPERATOR OR PATIENT FRO ELECTRIC SHOCK, ECHANICAL OR OTHER HAZARDS. 3

TABLE OF CONTENTS 0 INTRODUCTION 6 1 IPLEENTATION ODEL 6 1.1 Application Data Flow Diagram 6 1.2 Functional Definition of AE s 7 1.3 Sequencing of Real-World Activities 7 2 AE SPECIFICATIONS 7 2.1 DICO Server AE Specification 7 2.1.1 Association Establishment Policy 8 2.1.1.1 General 8 2.1.1.2 Number of Associations 8 2.1.1.3 Asynchronous Nature 8 2.1.1.4 Implementation Identifying Information 8 2.1.2 Association Initiation by Real-World Activity 9 2.1.2.1 Push Image(s) to Remote AE 9 2.1.2.1.1 Associated Real-World Activity 9 2.1.2.1.2 Proposed Presentation Contexts 9 2.1.2.1.2.1 SOP Specific Conformance Statement for Image Storage SOP Classes 9 2.1.3 Association Acceptance Policy 10 2.1.3.1 Verification Request from Remote AE 10 2.1.3.1.1 Associated Real-World Activity 10 2.1.3.1.2 Presentation Context Table 10 2.1.3.1.2.1 SOP Specific Conformance to Verification SOP Class 11 3 COUNICATION PROFILES 11 3.1 Supported Communication Stacks (parts 8,9) 11 3.2 TCP/IP Stack 11 3.2.1 Physical edia Support 11 4 EXTENSIONS / SPECIALIZATIONS / PRIVATIZATIONS 12 5 CONFIGURATION 12 5.1 AE Title/Presentation Address apping 12 5.2 Configurable Parameters 12 6 SUPPORT OF EXTENDED CHARACTER SETS 12 4

APPENDIX A ODULES/ATTRIBUTES 13 5

0 INTRODUCTION This Conformance Statement (CS) specifies the CT Synergy Scanner System compliance to DICO v3.0. It details the DICO Service Classes and roles which are supported by this product from version 3.1. The CT Synergy product uses DICO services to export images to other DICO compliant machines. Note the format of this section follows the format of the DICO Standard Part 2 (conformance) Annex A hence the paragraph numbering scheme. Please refer to that part of the standard while reading this section. 1 IPLEENTATION ODEL All DICO functionality on the CT Synergy product is handled by the DICO Server Application Entity (AE). The DICO Server AE is commanded to perform DICO services through the buttons and menu selections on software user interface. The DICO Server AE is also listening to a pre-defined port for incoming connections..1 Application Data Flow Diagram ILLUSTRATION 1.1-1 IPLEENTATION ODEL DATA FLOW DIAGRA There is one local Real-World Activity, Choose Push Option, which can cause the DICO Server Application Entity (DICO Server AE) to initiate a DICO association to a remote DICO Application Entity. The Choose Push Option Real-World activity consists of an operator selecting one or more study, series or image in the Patient List and choosing either Push Examination, Push Series or Push Image from the Network 6

pulldown menu on the Patient List to send the image(s) to a selected destination. There is no Real-World activity required for the DICO Server AE to respond to an incoming association request. The DICO Server AE is always prepared to respond to an association request by any remote DICO AE..2 Functional Definition of AE s DICO Server Application Entity initiate the following operation: Initiate an association to a Remote AE to send image(s). If the Remote AE accepts the presentation context applicable to the image(s) being sent, the DICO Server AE will send the image(s) by invoking C- STORE-RQ operation for each image on the same association. The DICO Server AE waits for association requests from Remote AEs that wish to perform the following operation: Verification: If a C-ECHO-RQ message is received, the DICO Server AE will send back a C-ECHO-RSP message with a status of success..3 Sequencing of Real-World Activities Not Applicable. 2 AE SPECIFICATIONS.1 DICO Server AE Specification This Application Entity provides Standard Conformance to the following DICO V3.0 SOP Classes as an SCU: SOP Class Name (SCU) SOP Class UID CT Image Storage 1.2.840.10008.5.1.4.1.1.2 Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.7 This Application Entity provides Standard Conformance to the following DICO v3.0 SOP classes as an SCP: SOP Class Name (SCP) SOP Class UID Verification (Echo) 1.2.840.10008.1.1 7

.1 Association Establishment Policy.1 General The DICO Application Context Name (ACN), which is always proposed, is: Application Context Name 1.2.840.10008.3.1.1.1 The aximum Length PDU negotiation is included in all association establishment requests. The maximum PDU length for association initiated by the DICO Server AE is: aximum Length PDU 10240 bytes The maximum PDU length for association accepted by the DICO Server AE is: aximum Length PDU 51200 bytes SOP class Extended Negotiation is not supported. The maximum number of Presentation Context Items that is supported is 20. Note that the same Abstract Syntax may be offered multiple times with different Transfer Syntaxes. The user information items sent by this product are: aximum PDU Length and, Implementation Class UID.2 Number of Associations The DICO Server AE (SCU) will initiate only one DICO association at a time to perform an image store to a remote host. The DICO Server AE (SCP) can have a maximum of four DICO associations open simultaneously to respond to an echo..3 Asynchronous Nature Asynchronous mode is not supported. All operations will be performed synchronously..4 Implementation Identifying Information The Implementation Class UID for this CT Synergy Implementation is: CT Synergy Implementation Class UID 1.2.840.113619.6.5 8

.2 Association Initiation by Real-World Activity This AE attempts to initiate a new association due to a Push operation initiated by the operator. There is one Real-World Activity (image transfer) to consider..1 Push Image(s) to Remote AE.1 Associated Real-World Activity The operator must first select a destination by choosing Select Remote Host from the Network pull-down menu and then choose a hostname. The operator then selects one or more study, series, or images in the Patient List and then chooses either Push Examination, Push Series, or Push Image from the Network pull-down menu on the Patient List. This operation causes: the system to build a DICO image from its data. the initiation of a DICO negotiation with the Remote Host AE. the emission of C-STORE command if negotiation is successful. Note: If multiple study, series, or images are chosen to be pushed, one association will be established for each of the studies, series, or images..2 Proposed Presentation Contexts The following table shows the proposed presentation contexts for the DICO Server AE after Real-World Activity Push Operation has been performed. Table 2.1.2.1.2-1 Proposed Presentation Contexts for DICO Server AE and Real-World activity Push Image(s) Presentation Context Table - Proposal Abstract Syntax Transfer Syntax Role Extended Negotiation Name UID Name List UID List CT Image Storage 1.2.840.10008.5.1.4.1.1.2 Implicit VR Little Endian Secondary Capture 1.2.840.10008.5.1.4.1.1.7 Implicit VR Little Image Storage Endian 1.2.840.10008.1.2 SCU None 1.2.840.10008.1.2 SCU None.1 SOP Specific Conformance Statement for Image Storage SOP Classes This implementation can perform multiple C-STORE operations over a single association. Upon receiving a C-STORE confirmation containing a Successful status, this implementation will perform the next C-STORE operation. The association will be maintained if possible. 9

Upon receiving a C-STORE confirmation containing a Refused status, this implementation will terminate the association. The current request (exam(s), series(s) or image(s)) is considered failed. Upon receiving a C-STORE confirmation containing any status that is not Success or Refused, this implementation will consider the current request to be a failure but will continue to attempt to send the remaining images in the request on the same association. Each association negotiation supports an Association Timer. This timer starts when the association request is sent and stops when the association is established. The time-out is 30 seconds. Each C-STORE operation supports an Operation Inactivity Timer. This time-out starts once the first C-STORE request has been issued (after association establishment) and is reset each time a C-STORE response has been received or when subsequent C-STORES are sent. This time-out is 90 seconds. Each C-STORE operation also supports a Session Timer. This timer starts when the association is established and stops when the association is ended. This time-out is 60 minutes. If any of the three timers mentioned above expires, the connection is closed and the operation in progress is considered failed. When DICO Server AE initiates an association to issue a C-STORE, the following operation will be performed: The selected images(ct images and/or Secondary Capture images) will be transmitted by the DICO Server AE with the same elements as was originally created locally. Refer to Appendix A for the list modules and attributes that this product supports..3 Association Acceptance Policy The DICO Server AE places no limitations on who may connect to it. Any remote AE can open an association to the DICO Server AE for the purpose of verification..1 Verification Request from Remote AE This AE is indefinitely listening for associations. No operator action is required to respond to a verification message..1 Associated Real-World Activity The Real-World Activity associated with the verification request is to send a C-ECHO response message with a status of success to the requesting AE..2 Presentation Context Table 10

Table 2.1.3.1.2-1: Acceptable Presentation Contexts for DICO Server AE and Real-World Activity, Verification Request Presentation Context Table Abstract Syntax Transfer Syntax Role Extended Negotiation Name UID Name List UID List Verification 1.2.840.10008.1.1 Implicit VR Little Endian 1.2.840.10008.1.2 SCP None.1 SOP Specific Conformance to Verification SOP Class The DICO Server AE provides standard conformance to the DICO Verification Service Class. Each association negotiation supports an Association Timer. This timer starts when the association request is received and stops when the association is established. The time-out is 30 seconds. Each C-ECHO operation supports an Operation Inactivity Timer. This timeout starts once the first C-ECHO is received and is reset each time a C- ECHO response is sent. This time-out is 30 seconds. Each C-ECHO operation also supports a Session Timer. This timer starts when the association is established and stops when the association is ended. This time-out is 60 minutes. If any of the three timers mentioned above expires, the connection is closed and the operation in progress is considered failed. 3 COUNICATION PROFILES.1 Supported Communication Stacks (parts 8,9) DICO Upper Layer (Part 8) is supported using TCP/IP..2 TCP/IP Stack The TCP/IP stack is inherited from a UNIX Operating System..1 Physical edia Support The DICO Server AE is indifferent to the physical medium over which TCP/IP executes; they inherit this from the UNIX system upon which they execute. 11

4 EXTENSIONS / SPECIALIZATIONS / PRIVATIZATIONS Not Applicable. 5 CONFIGURATION.1 AE Title/Presentation Address apping The CT Synergy Scanner System allows the user to add, Remove, or Update the mapping of remote AE Titles to IP Addresses and Ports. These options can be selected from the Remote Host Selection menu displayed by choosing Select Remote Host from the Network pull-down menu on the Patient List..2 Configurable Parameters The following fields are configurable for the DICO Server AE: Local AE Title (the machine hostname) Local IP Address Note: (i) All configurations for local AE must be performed by a GE Field Engineer. (ii) The local port on which the CT Synergy Scanner System receives the incoming TCP/IP connections is port 4006. The following fields are configurable for every remote DICO AE: Remote AE Title Responding TCP/IP Port Remote IP Address 6 SUPPORT OF EXTENDED CHARACTER SETS Appendix A No extended character sets are supported. 12

odules/attributes Enclosed is the listing of modules and attributes used by this implementation for CT IOD. A.1 CT Image IOD A.1.1 CT Image IOD odules IE odule Reference Usage (DICO PS3.3) Patient Patient C.7.1.1 Study General Study Patient Study C.7.2.1 C.7.2.2 U Series General Series C.7.3.1 Frame of Reference Frame of Reference C.7.4.1 Equipment General Equipment C.7.5.1 Image General Image Image Plane Image Pixel Contrast Bolus CT Image VOI LUT SOP Common C.7.6.1 C.7.6.2 C.7.6.3 C.7.6.4 C.8.2.1 C.11.2 C.12.1 C U A.1.2 CT Image attributes(odule wise) A.1.2.1 Patient odule Patient Name (0010,0010) 2 Patient ID (0010,0020) 2 Patient s Birth Date (0010,0030) 2 Patient s Sex (0010,0040) 2 A.1.2.2 General Study odule Study Instance UID (0020,000D) 1 Study Date (0008,0020) 2 Study Time (0008,0030) 2 Referring Physician s Name (0008,0090) 2 Study ID (0020,0010) 2 Accession Number (0008,0050) 2 Study Description (0008,1030) 3 A.1.2.3 Patient Study odule Patient s Age (0010,1010) 3 A.1.2.4 General Series odule 13

odality (0008,0060) 1 Series Instance UID (0020,000E) 1 Series Number (0020,0011) 2 Laterality (0020,0060) 2C Protocol Name (0018,1030) 3 Patient Position (0018,5100) 2C A.1.2.5 Frame of Reference odule Frame of Reference (0020,0052) 1 Position Reference Indicator (0020,1040) 2 A.1.2.6 General Equipment odule anufacturer (0008,0070) 2 Station Name (0008,1010) 3 anufacturers odel Name (0008,1090) 3 Software Versions (0018,1020) 3 Pixel Padding Value (0028,0120) 3 A.1.2.7 General Image odule Image Number (0020,0013) 2 Image Date (0008,0023) 2C Image Time (0008,0033) 2C Image Type (0008,0008) 3 Acquisition Number (0020,0012) 3 Acquisition Date (0008,0022) 3 Acquisition Time (0008,0032) 3 A.1.2.8 Image Plane odule Pixel Spacing (0028,0030) 1 Image Orientation (Patient) (0020,0037) 1 Image Position (Patient) (0020,0032) 1 Slice Thickness (0018,0050) 2 Image Slice Location (0020,1041) 3 A.1.2.9 Image Pixel odule Samples Per Pixel (0028,0002) 1 Photometric Interpretation (0028,0004) 1 Rows (0028,0010) 1 Columns (0028,0011) 1 Bits Allocated (0028,0100) 1 Bits Stored (0028,0101) 1 High Bit (0028,0102) 1 Pixel Representation (0028,0103) 1 Pixel Data (7FE0,0010) 1 14

Smallest Image Pixel Value (0028,0106) 3 A.1.2.10 Contrast/Bolus odule Contrast/Bolus Agent (0018,0010) 2 A.1.2.11 CT Image odule Image Type (0008,0008) 1 Samples per Pixel (0028,0002) 1 Photometric Interpretation (0028,0004) 1 Bits Allocated (0028,0100) 1 Bits Stored (0028,0101) 1 High Bit (0028,0102) 1 Rescale Intercept (0028,1052) 1 Rescale Slope (0028,1053) 1 KVP (0018,0060) 2 Acquisition Number (0020,0012) 2 Scan Options (0018,0022) 3 Date Collection Diameter (0018,0090) 3 Reconstruction Diameter (0018,1100) 3 Distance Source to Detector (0018,1110) 3 Distance Source to Patient (0018,1111) 3 Gantry / Detector Tilt (0018,1120) 3 Table Height (0018,1130) 3 Rotation Direction (0018,1140) 3 Exposure Time (0018,1150) 3 Xray Tube Current (0018,1151) 3 Convolution Kernel (0018,1210) 3 A.1.2.12 VOI LUT odule Window Center (0028,1050) 3 Window Width (0028,1051) 1C A.1.2.13 SOP Common odule SOP Class UID (0008,0016) 1 SOP Instance UID (0008,0018) 1 15

A.2 Secondary Capture(SC) Image IOD Note : In the usage section of the following appendix, [ * ] indicates the element is not currently formatted in the image. A.2.1 SC Image IOD odules IE odule Reference Usage (DICO PS3.3) Patient Patient C.7.1.1 Study General Study Patient Study C.7.2.1 C.7.2.2 U Series General Series C.7.3.1 Equipment General Equipment SC Equipment C.7.5.1 C.8.6.1 Image General Image Image Pixel SC Image Overlay Plane odality LUT VOI LUT SOP Common C.7.6.1 C.7.6.3 C.8.6.2 C.9.2 C.11.1 C.11.2 C.12.1 U U U A.1.2 CT Image attributes(odule wise) A.2.2.1 Patient odule Patient Name (0010,0010) 2 Patient ID (0010,0020) 2 Patient s Birth Date (0010,0030) 2 Patient s Sex (0010,0040) 2 Referenced Patient Sequence (0008,1120) 3 A.2.2.2 General Study odule Study Instance UID (0020,000D) 1 Study Date (0008,0020) 2 Study Time (0008,0030) 2 Referring Physician s Name (0008,0090) 2 Study ID (0020,0010) 2 Accession Number (0008,0050) 2 Study Description (0008,1030) 3 16

A.2.2.3 Patient Study odule None. A.2.2.4 General Series odule odality (0008,0060) 1 Series Instance UID (0020,000E) 1 Series Number (0020,0011) 2 Laterality (0020,0060) 2C A.2.2.5 General Equipment odule anufacturer (0008,0070) 2 Institution Name (0008,0080) 3 Station Name (0008,1010) 3 anufacturers odel Name (0008,1090) 3 A.2.2.6 SC Equipment odule None. A.2.2.7 General Image odule Image Number (0020,0013) 2 Image Date (0008,0023) 2C Image Time (0008,0033) 2C Image Type (0008,0008) 3 A.2.2.8 Image Pixel odule Samples Per Pixel (0028,0002) 1 Photometric Interpretation (0028,0004) 1 Rows (0028,0010) 1 Columns (0028,0011) 1 Bits Allocated (0028,0100) 1 Bits Stored (0028,0101) 1 High Bit (0028,0102) 1 Pixel Representation (0028,0103) 1 Pixel Data (7FE0,0010) 1 A.2.2.9 SC Image odule None. A.2.2.10 Overlay Plane odule None. The overlay plane module is not used as graphics and text annotations are burned into pixel data. A.2.2.11 odality LUT odule Rescale Intercept (0028,1052) 1C Rescale Slope (0028,1053) 1C A.2.2.12 VOI LUT odule Window Center (0028,1050) 3 17

Window Width (0028,1051) 1C A.2.2.13 SOP Common odule SOP Class UID (0008,0016) 1 SOP Instance UID (0008,0018) 1 Note : 3D Reformatted Images Following conditional element is currently not encoded in the image. Attribute Tag Type odule Notes Name Rescale Type (0028,1054) 1C odality LUT (C.11.1). Following retired element is encoded in the image. Attribute Name Tag Length to End (0008,0001) Following elements are encoded in the image. Attribute Tag Type odule Notes Name Slice Thickness (0018,0050) 2 Image Plane (C.7.6.2) Spacing between Slices (0018,0088) 3 (C.8.3.1) Screen Save Images Following mandatory element is currently not encoded in the image. Attribute Tag Type odule Notes Name Conversion Type (0008,0064) 1 SC Equipment (C.8.6.1) Following conditional element is not encoded in the image Attribute Tag Type odule Notes Name Rescale Type (0028,1054) 1C odality LUT (C.11.1) 18

Following retired elements are present in the image. Attribute Name Tag Length to End (0008,0001) Data Set SubType (0008,0041) Additional attributes for Standard Extended Secondary Capture Image IOD Attribute Name Tag Type odule Contrast/Bolus Agent (0018,0010) 2 Contrast/Bolus (C.7.6.4) Scan Options (0018,0022) 3 CT Image (C.8.2.1) Slice Thickness (0018,0050) 2 Image Plane KVP (0018,0060) 2 CT Image (C.8.2.1) Data Collection Diameter (0018,0090) 3 CT Image (C.8.2.1) Reconstruction Diameter (0018,1100) 3 CT Image (C.8.2.1) Distance Source to Diameter (0018,1110) 3 CT Image (C.8.2.1) Distance Source to Patient (0018, 1111) 3 CT Image (C.8.2.1) Gantry/Detector Tilt (0018, 1120) 3 CT Image (C.8.2.1) Table Height (0018, 1130) 3 CT Image (C.8.2.1) Rotation Direction (0018, 1140) 3 CT Image (C.8.2.1) Exposure Time (0018, 1150) 3 CT Image (C.8.2.1) Xray Tube Current (0018, 1151) 3 CT Image (C.8.2.1) Convolution Kernel (0018, 1210) 3 CT Image (C.8.2.1) Image Position (Patient) (0020,0032) 1 Image Plane (C.7.6.2) Image Orientation (0020,0037) 1 Image Plane (C.7.6.2) Frame of Reference UID (0020,0052) 1 Frame of Reference (C.7.4.1) Position Reference Indicator (0020,1040) 2 Frame of Reference (C.7.4.1) Slice Location (0020,1041) 3 Image Plane (C.7.6.2) Pixel Spacing (0028,0030) 1 Image Plane (C.7.6.2) 19